Tanq 1, LTD.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

019023351 Issued in IL

Legal business name

TANQ 1, LTD.

Doing business as

Randallwood Dental

Practice address

1546 East Main St.
St Charles, IL 60174

Phone

(630) 377-0034

Fax

(630) 377-3877

NPI assigned

May 2, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Rene Tanquilut, D.D.S.NPI 1689686628

Title

President / Owner

Phone

(630) 377-0034

Specialties & licenses 1

Addresses

Other names 1

• Randallwood Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rene Tanquilut, DDS

  • Dentist
  • Oak Park, IL
  • NPI 1689686628
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623196800000",
    "number": "1093160715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1546 EAST MAIN ST.",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "60174",
            "telephone_number": "630-377-0034",
            "fax_number": "630-377-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1546 EAST MAIN ST.",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "60174",
            "telephone_number": "630-377-0034",
            "fax_number": "630-377-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANQ 1, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-02",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "TANQUILUT",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "630-377-0034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019023351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Randallwood Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Randallwood Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brenda Joyce Sypolt
• Taag Genetics Corp.
• Laura Koeppel Tagle, MD
• Nile Kenneth Tallman, LCPC
• Jenny Tan, MD
• Nicholas J Tapas, M.D.
• Jenna Tarran, DPT
• Loyal Tate
• Rosemary Taylor, PH.D.
• Laura Anne Ternand-Hughes, PSY.D.

• Dental Clinic/Center in St Charles, IL
• Providers in St Charles, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.